Abstract：
OBJECTIVE:To determine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. METHODS:A three-year experimental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Cameroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions - vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients - were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. FINDINGS:With the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problems with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. CONCLUSION:The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa.
journal_name
Bull World Health Organjournal_title
Bulletin of the World Health Organizationauthors
CDI Study Group.doi
10.2471/BLT.09.069203subject
Has Abstractpub_date
2010-07-01 00:00:00pages
509-18issue
7eissn
0042-9686issn
1564-0604journal_volume
88pub_type
杂志文章,多中心研究,随机对照试验abstract：OBJECTIVE:To compare the effectiveness of oral ivermectin (IV) and two different modalities of topical benzyl benzoate (BB) for treating scabies in a community setting. METHODS:The trial included patients aged 5-65 years with scabies who attended the dermatology department at the Institut d'Hygiène Sociale in Dakar, S...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章,随机对照试验
doi：10.2471/blt.08.052308
更新日期：2009-06-01 00:00:00
abstract：:To determine whether there are major differences in the distribution of Streptococcus pyogenes serotypes in different countries and to compare the typing results obtained in different laboratories with the same cultures, an international survey of the distribution of such serotypes was carried out in 1964-65 in 12 lab...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1967-01-01 00:00:00
abstract：:In a field study conducted in Burma, 54 semi-immune adults suffering from falciparum malaria (mean parasite count, 15 328/mm(3) before treatment) were given a single dose of a fixed combination of 750 mg mefloquine base, 1500 mg sulfadoxine, and 75 mg pyrimethamine (3 tablets of Fansimef). All these patients were clea...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:The magnitude of the malaria problem in tropical Africa has been a deterrent to a large-scale control effort as long as the aim was conceived to be only a reduction in transmission. The focus on local priorities brought about by the primary health care approach has resulted in the formulation of a strategy of malaria ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:To assess its potential applications in plague surveillance and control programmes, an enzyme-linked immunosorbent assay (ELISA) that captures the specific Yersinia pestis F1 antigen was used to determine the amounts of this antigen present in samples of blood and spleens from laboratory rats with acute plague, in the...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：:There is a need to reassess the role of the trypanosomiases, both human and animal, in African ecology and economy. Withdrawal of control services from the Congo basin was followed by a resurgence of infection from ancient foci, many of them thought to have been extinguished. Successful elimination of Glossina in sava...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1969-01-01 00:00:00
abstract：:In March 1990 a study was carried out in the village of Kicheba, United Republic of Tanzania, in which the pyrethroid insecticide lambda-cyhalothrin was sprayed on all the internal surfaces of houses and other shelters at a coverage of about 25 mg of active ingredient per m2. Every day for 6 days, 12 spraymen and 3 sq...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：:Tuberculosis (TB) is a major public health problem in eastern Europe. Since 1990, the incidence rates of TB have continued to increase in Belarus, the Russian Federation, the Ukraine and the central Asian republics of Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan. Eastern Europe, and in particular the Russian Fede...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章,评审
doi：10.2471/blt.06.034991
更新日期：2008-02-01 00:00:00
abstract：OBJECTIVE:To assess maternal and neonatal health services in 49 developing countries. METHODS:The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these servi...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：2002-01-01 00:00:00
abstract：:Investigators using questionnaires are usually confronted with an enormous number of different responses whose significance with respect to a particular characteristic is not immediately clear. This paper presents a simple computational technique for determining the relative merits of each question and a score for eac...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1972-01-01 00:00:00
abstract：:The Haemosporidia, which comprise the malaria parasites, have probably evolved from Coccidia of the intestinal epithelium of the vertebrate host by adaptation first to some tissues of the internal organs and then to life in the circulating cells of the blood.The present opinion is that, among the malaria parasites of ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1965-01-01 00:00:00
abstract：:The results of a WHO-assisted survey of the distribution of Q fever in 32 countries and an analysis of reports published to date indicate that Q fever exists in 51 countries on five continents. Q-fever infection was most often reported in man and the domestic ruminants, such as cattle, sheep, and goats.The disease was...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1955-01-01 00:00:00
abstract：:Options for health financing reform are often portrayed as a choice between general taxation (known as the Beveridge model) and social health insurance (known as the Bismarck model). Ten years of health financing reform in Kyrgyzstan, since the introduction of its compulsory health insurance fund in 1997, provide an e...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：10.2471/blt.07.049544
更新日期：2009-07-01 00:00:00
abstract：:In an attempt to prepare highly specific antiserum to variola virus, a chimpanzee was inoculated with a virulent human strain of this virus. Three uninoculated chimpanzees were housed in the same room; two of these developed clinical disease with seroconversion, while the third developed no evidence of infection and n...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:The treatment received by children aged under 5 years with diarrhoea was studied in the Hospital Infantil de México (Federico Goméz), Mexico City. The costs of treatment were calculated and estimates were made of how these had changed since the establishment of an oral rehydration unit in the hospital in 1985. The res...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1989-01-01 00:00:00
abstract：:In order to evaluate results obtained in Addis Ababa with lipoidal antigen tests for syphilis on 269 human sera, and, if possible, to determine how many positive seroreactors were in fact infected with Treponema pallidum, these sera were sent by air to Copenhagen for re-examination by the VDRL, Kahn, CWRM and TPI test...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1964-01-01 00:00:00
abstract：:Several laboratories have reported a large number of plasmodial antigens that may be implicated in the immune-mediated protection against the asexual blood stage of Plasmodium falciparum. In order to establish relationships between the antigens reported by different laboratories, a comparative testing of 37 antibody r...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：:The plaque-neutralization method developed by Dulbecco and co-workers for the study of the virus of western equine encephalomyelitis in cultures of chick fibroblasts, though probably unequalled for accuracy, has not been adopted for general use in laboratories engaged in research on the arthropod-borne viruses, for tw...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1960-01-01 00:00:00
abstract：:The HemoCue system utilizes the principle of oxidation of haemoglobin to hemiglobin by sodium nitrite and the subsequent conversion of hemiglobin to hemiglobinazide by sodium azide. The reagents for these reactions are contained within a small disposable microcuvette of approximately 10 microliters in volume. A venous...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1994-01-01 00:00:00
abstract：:There have been 4 waves of imported malaria in the USA. They occurred during the colonization of the country and during the Second World War, the UN Police Action in Korea, and the Viet-Nam conflict. The first 3 episodes are briefly described and the data on imported malaria from Viet-Nam are discussed in detail.Endem...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1974-01-01 00:00:00
abstract：:The author describes the design and operation of an automatic molluscicide dispenser for use in flowing water. The equipment, which consists basically of a measuring weir coupled to a float-activated siphon, was designed for simplicity, low cost, construction with commonly available materials, and operation by untrain...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1956-01-01 00:00:00
abstract：:In November 1999, Dr Amadou Diarra was appointed senior director of Bristol-Myers Squibb's Secure the Future Initiative. Launched 18 months ago, this public-private partnership is seeking, together with the governments of nine African countries, innovative ways of reducing the transmission and the impact of HIV/AIDS, ...
journal_title：Bulletin of the World Health Organization
pub_type： 面试
doi：
更新日期：2001-01-01 00:00:00
abstract：:Selective population chemotherapy using a single dose of praziquantel (40 mg per kg body weight), which was offered to 29,365 schoolchildren in Abu El Matameer and 40,241 in Abo Homos districts, Beheira governorate in the Nile delta, reduced the prevalence of schistosomiasis from 75.4% to 40.9% (reduction of 45.8%) an...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：:There is a need for additional data on the distribution of pneumococcal serotypes in developing countries. We report the use of a coagglutination (COA) and a latex agglutination (LA) test for serotyping Streptococcus pneumoniae which were evaluated using 114 clinical isolates in Vellore, India. In tests to serotype 30...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
abstract：:Data on the dynamics of the tuberculosis situation in rural South India, obtained by the National Tuberculosis Institute, Bangalore, were fed into a mathematical model. By this means predictions about the future tuberculosis situation have been made under a wide range of hypothetical assumptions. ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1974-01-01 00:00:00
abstract：:In the current information age, research synthesis is a particularly useful tool for keeping track of scientific research and making sense of the large volumes of frequently conflicting data derived from primary studies. The Cochrane Collaboration is a global initiative "to help people make well-informed decisions abo...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章,评审
doi：
更新日期：2004-10-01 00:00:00
abstract：OBJECTIVE:To evaluate the implementation of a programme to provide primary care physicians for remote and deprived populations in Brazil. METHODS:The Mais Médicos (More Doctors) programme was launched in July 2013 with public calls to recruit physicians for priority areas. Other strategies were to increase primary car...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：10.2471/BLT.16.178236
更新日期：2017-02-01 00:00:00
abstract：:The United Republic of Tanzania is the first mainland sub-Saharan country to launch a national methadone programme as part of its battle to fight the twin epidemics of heroin addiction and HIV infection. Fumbuka Ng'wanakilala reports. ...
journal_title：Bulletin of the World Health Organization
pub_type： 新闻
doi：10.2471/BLT.13.030213
更新日期：2013-02-01 00:00:00
abstract：OBJECTIVE:To determine whether a complex community intervention in rural Zambia improved understanding of maternal health and increased use of maternal health-care services. METHODS:The intervention took place in six rural districts selected by the Zambian Ministry of Health. It involved community discussions on safe ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：10.2471/BLT.13.122721
更新日期：2014-01-01 00:00:00
abstract：:The unacceptably high mortality related to acute respiratory infections (ARI) in children, recognition of the importance of bacteria in the causation of severe acute lower respiratory infection in developing countries, and the established effectiveness of antimicrobial and supportive treatment in averting death make a...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
